JAMES Graham believes the brain injury which has ruled Eliesa Katoa out for the entire 2026 season will have a far-reaching impact across the NRL.
The Melbourne Storm back row underwent surgery to relieve bleeding on his brain following Tonga’s Pacific Championship match against New Zealand in Auckland on November 2 in which he suffered three head injuries and seizures on the sideline.
Former England international Graham, who sits on the Concussion Legacy Foundation Australia board, expects the shocking incident will lead to expanding the definition of the highest level of head injury as well as change attitudes among players and coaches.
- Super League defends leaving no room in draw for England international
- Magic Weekend 2026: Better transport links and more line markings for Everton
- Subscribe to Rugbyleaguehub.com on YouTube
“I think we’ll see a tightening up or a broadening of what is a Category 1,” Graham told his The Bye Round podcast. “I think you’ll likely see this year more Cat 1s and incidents that would have been Cat 2s in season 2025.
“I also feel players, individuals all throughout other different roles in the game, having seen this example, will change.
“My thoughts are with Katoa and people like [Tonga head coach] Kristian Woolf who have to endure this as well.
“We don’t know what has happened there and the investigation will show whatever happened, but there will be a number of people in and around Katoa who will be feeling beyond horrendous at the moment and I think that will change the shift in attitude, potentially.”
Graham has become one of rugby league’s foremost advocates for greater awareness around the dangers of concussion since retiring from playing at the 2020 season.
The former St Helens, Canterbury Bulldogs and St George Illawarra Dragons prop estimates he suffered over 100 concussions during his 17-year playing career, and warned of the danger particularly posed by sustaining repeated blows to the head in the same game.
“The recognition of the importance of second-impact syndrome – I, arguably stupidly, put myself in that position,” Graham said.
“It’s not something I look back on with any level of pride, but I was who I was and I risked severe brain injury. That is my undertaking, that is something I entered into voluntarily, and I don’t need any pats on the back or congratulating for it because it’s arguable stupid.
“But, that doesn’t mean the culture can’t change and it really should. Sometimes, people talking about second-impact syndrome, it has severe consequences for a lot of people across the world, and sometimes you need a visual example of that and that’s what we’ve seen with Eli Katoa.
“I think most people in and around his family and doctors would say they’re grateful that he’s here, never mind the year he’ll sit out and what happens after that.”
The NRL is investigating the circumstances which led to Katoa having to undergo surgery and being allowed to play after appearing to suffering a concussion during Tonga’s warm-up.
He suffered two further head impacts during the second half against the Kiwis and required oxygen on the sideline as his condition deteriorated.
Graham wants to see league follow the example of rugby union by bringing in microchipped mouthguards which measure impacts and can alert pitchside doctors to bring players off for head injury assessments if a certain threshold of force is exceeded.
“There is no threshold which can diagnose a concussion with absolute accuracy,” Graham said.
“But within rugby union they have that threshold which once it’s crossed, the alert will go to a sideline doctor [the player] has been involved in a collision which is over the threshold and they need to be removed for a head assessment.
“There will maybe some pushback from some players who don’t like wearing mouthpieces…and that’s fine.
“But, again, what is new tomorrow will be culturally normal in five years’ time.”